Provider First Line Business Practice Location Address:
3801 E 42ND ST
Provider Second Line Business Practice Location Address:
HEB PHARMACY
Provider Business Practice Location Address City Name:
ODESSA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79762-5947
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
432-362-4555
Provider Business Practice Location Address Fax Number:
432-362-4514
Provider Enumeration Date:
09/25/2005